Document Detail

Facial edema induced by isotretinoin use: a case and a review of the side effects of isotretinoin.
MedLine Citation:
PMID:  16703787     Owner:  NLM     Status:  MEDLINE    
Isotretinoin (13-cis-retinoic acid) is a retinoid that is used to treat cystic acne, comedonal acne, and other diseases. For the treatment of acne, isotretinoin is dosed at 0.5 to 2 mg/kg daily for 5 months with a target total dose of approximately 120 mg/kg. Its most common side effects are mucocutaneous and ocular in nature (ie, cheilitis, ocular sicca, and decreased dark adaptation). It can also cause xerosis. Patients should be made aware of these side effects before taking isotretinoin and also that utilization of moisturizers and eye drops can help to mitigate such side effects. Sometimes, however, the dose of isotretinoin needs to be decreased to reduce the induction of side effects. Isotretinoin's most significant side effect is the induction of birth defects if a fetus is exposed to isotretinoin, which is pregnancy category X. Isotretinoin should be used with 2 forms of birth control by fecund women. It can rarely increase serum levels of triglycerides, which can, if very elevated, be related to the development of pancreatitis and xanthomas. Isotretinoin's well-documented but rarer side effects include intracranial hypertension. It can induce bony changes. A review of the literature demonstrates that isotretinoin is not linked to depression and suicide. Facial swelling has been linked to isotretinoin use in 3 previous case reports. We note herein the first case of facial swelling that occurred in an acne patient being treated with isotretinoin who at the time the swelling developed had no cysts, comedones, pustules, or evidence of bacterial infection. Possible reasons for the patient's facial swelling include some type of retinoid induced angioedema, exacerbation of inflammation by isotretinoin, and isotretinoin induced capillary leak syndrome.
Noah Scheinfeld; Sripal Bangalore
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of drugs in dermatology : JDD     Volume:  5     ISSN:  1545-9616     ISO Abbreviation:  J Drugs Dermatol     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-17     Completed Date:  2006-07-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160020     Medline TA:  J Drugs Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  467-8     Citation Subset:  IM    
Department of Dermatology, St. Luke's-Roosevelt Hospital, New York, NY 10025, USA.
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MeSH Terms
Acne Vulgaris / diagnosis,  drug therapy*
Administration, Topical
Dose-Response Relationship, Drug
Drug Administration Schedule
Edema / chemically induced*,  physiopathology
Follow-Up Studies
Isotretinoin / adverse effects*,  therapeutic use
Risk Assessment
Severity of Illness Index
Reg. No./Substance:

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